John Fleming

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, recently the IMF announced a giant bailout to keep Greece from defaulting, defaulting on its own debt, debt for its socialistic economy. The U.S. is the largest contributor to the IMF; therefore, we are the largest bailout source for this. That's right, Mr. Speaker, the U.S. taxpayer is now in the business of rescuing Greece from its debt crisis, which was brought on by reckless borrowing and spending to fund welfare programs. While the U.S. is putting itself on the hook for another bailout, liberals in Washington are working hard to copycat the Greek model: taxing, spending, borrowing, and increasing entitlement programs across the board. Behind Greece are other European countries on the verge of default. Are we going to bail them out, too? And that's not to mention States like California and the many companies this government has already bailed out. Who will bail out our country when we can't borrow our way out of trouble? Mr. Speaker, let's stop bailing out countries, States, and companies, and hold all entities, including ourselves, accountable for runaway spending.

Mr. FLEMING

Mr. FLEMING. I thank the gentleman. I won't need much time to close out my remarks, and that is that, again, the Federal Government has failed to do its job. It's failed to protect its citizens, it's failed to protect its borders, it's failed to protect its sovereignty. And we have a State, the State of Arizona, which has stepped up, very carefully crafted a law that mirrors that of the Federal Government that's not being enforced. They've stepped up to the plate and said this is costing us in terms of human lives, really. And in terms of other costs, financial and otherwise, we're better off to step forward and do something about this even though the Federal Government refuses to send troops or whatever protection we need to have. So I think that that is the beauty of this Republic, and that is that each State has its own government and becomes a test tube for the entire Nation. It's going to be very interesting going forward to see what the results of this in Arizona are, and I think the results are going to be very good. And I think very soon we're going to see other States replicating this, and it will force the hand of the Federal Government to finally step up and do the right thing. And with that, I yield back

Mr. FLEMING. I thank the gentleman from Iowa. I would like to state emphatically here this evening, Mr. Speaker, that I support the law of Arizona. Just as the gentleman said, it is really a mirror image of the United States law. I would say that those who are against the law who criticize it, some in our own government, do so for very interesting reasons. It is not really the law that they have such a problem with. It is the fact that we are enforcing a law that already exists. If that were not the case, then why, Mr. Speaker, do these people who are against this Arizona law, why don't they simply bring a bill to the floor and vote to repeal the existing American law. But that is not happening. What we have had is a wink and a nod for many years, in which case we have a law on the books--I think it is a good law, it is not a perfect law--but a law that if we enforced it, we wouldn't have the problems that we have today. Let's just take a moment to understand why we have the problems that we have. I lived in the San Diego, California, area some years ago, and it was very interesting. When you would leave San Diego and drive across the border into Tijuana, here we are, two cities that are so close together that they abut one another, and yet on one side of the border you have beautiful homes, million dollar homes. You have wonderful bridges and infrastructure. And then as you cross the border, you find poverty. You find dirt roads. You find people in some cases living in the streets. So there is such a chasm between the standard of living below the border than above that border, no wonder people try to cross the border for opportunity. I can't blame them for doing that. But the problem is that it's a cultural and political problem that exists in Mexico today. And so rather than pointing his finger at us, President Calderon should, I think, address the problems in his country, and that is the fact that they have a high level of corruption, a high level of poverty. I do agree with the gentleman from Iowa (Mr. King) that he is doing a much better job about the drug cartels and enforcing those laws than any President in modern times from Mexico, so I definitely tip my hat to him for that. But there is also no middle class in Mexico today. And like many third world countries, it's mostly a poverty-driven country, where many people are desperate for work and desperate for opportunities. But on the other hand, there is 10 percent or so of the population that lives a wealthy lifestyle. But there's very few opportunities for upward mobility. And let's just finally look at it. We're all descendents of immigrants at one point or another, and our ancestors came here because they were looking for opportunity. And we have many people around the world who come here looking for opportunity, and we have a way for them to do that. I think it was the gentleman from California earlier that mentioned that 600-something thousand legal immigrants came to this country last year. So we have a way of doing that, although we, I think, could make it better. We could make it more efficient. But the truth is there is a legal way to immigrate to the United States, and we should make that available, and we do make that available. On the other hand--and I welcome those immigrants. But on the other hand, those who come across our borders illegally, inappropriately, and who, in many ways, create danger for our own citizens, create problems for our own economy in terms of the need for education for their children and for health care, doing that illegally is not a solution to the problem. It may be a short-term solution for their immediate economic problems, but Mexico has got to address its own economic and cultural problems. And we, on the other hand, have got to take care of our borders, our sovereignty here. And so, again, I would just reiterate that I do support Arizona's bold move, I think a necessary move, to protect their borders, to protect their economy. I believe it's Phoenix that is considered the kidnapping capital of at least the United States, if not the world. And who can blame the people of Arizona for doing for themselves what the Federal Government refuses to do, even though it has an obligation to do that? And then, as the gentleman from Texas (Mr. Poe) points out, and the gentleman from Iowa (Mr. King) as well, we have the Attorney General sitting here today right in front of this body and having already admitted, confessed that he didn't read the law to begin with; and, after all, it's essentially the same law that he's agreed to uphold and defend as Attorney General, and somehow agreeing with the President from another country who says we should turn a blind eye to the illegal immigrants who are coming across the border. So I would just say that I agree with the two gentlemen here tonight. It's time something is done. And I agree with the efforts of Arizona, and I do think other States are going to take this up as well and come up with similar laws. And I think we here in the body of the U.S. Congress should also move forward with immigration reform, but not in the form of amnesty that we hear about from the other side, but a true reform where we can more efficiently allow people to come across the border to work here temporarily if there are jobs for them in a legal way, but make sure that they return when they're done; and, on the other hand, those who are here illegally return and never come back in an illegal status.

Mr. FLEMING. Would the gentleman yield?

Mr. FLEMING. I thank you for yielding. To expand on that point, I have spoken to a number of business owners who have said just that. They really do not want to hire illegals but feel compelled to because the only way they can compete is to do the very same thing that their competitors are doing as well. So even those who wish not to be corrupt and wish not to break the laws are forced either out of business or forced to violate those laws that we should be enforcing in the first place. But the other thing, just to touch on amnesty again, it seems like we have gone through this cycle twice before. And the first thing that we do towards a solution has been to generate amnesty. And where has it gotten us? We have more illegals in this country and more problems with illegals than we have ever had before. So if starting with amnesty with or without a fine was a solution to the problem, the problem would be solved already. So obviously amnesty is not the answer. So I oppose amnesty. I support the enforcement of the laws on the book, both Federal and the Arizona State laws, and perhaps other States that will take up those laws. And the other thing, Mr. Speaker, that I support is that English should be our national language. It's really I think insulting when you are in your own country and you have to sort through all sorts of phone messages to just get to the right language you should be in. If someone is serious enough about coming to this country and staying or working here, then I think they should at least make the effort to learn our language, at least the basics of our language. And rather than citizens being forced to in effect learn other people's languages just because they are coming here illegally, or in some cases legally. So those are I think three solid requirements that we should have: That we should have English as our official national language; that we should not grant amnesty under any sort of reform bill; and that we enforce the laws that exist on the book today. With that, I yield back.

Mr. FLEMING. I'd just like to expand on that point real quickly, and that is that we're moving rapidly in this country towards paying people not to work. So, obviously, that creates that vacuum that you're talking about where people from Mexico want to come across the border illegally to find jobs. But what's very interesting about President Calderon is, as I understand it, that the rules for immigration into Mexico from its southern border are far more onerous than our own laws. In fact, ours are much more generous, and yet he's again criticizing us. That really makes no sense. It doesn't add up. It's hypocritical, of course. So I think you're absolutely right, Mr. King, because not only should we make sure that the opportunities are there for our own citizens, but we should take away, I think, any incentives for people not to work when, in fact, they're fully able bodied to do so.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, last week, Governor Bobby Jindal announced that Louisiana, along with 16 other States, would not participate in the government takeover of health care's temporary high risk pools. I commend Governor Jindal on this decision and for having the foresight not to put Louisiana on the hook for yet another tax-increasing, job- killing, unfunded mandate, and subjecting our citizens to more Federal inefficiency and bureaucracy. While I have always supported the concept of high risk pools, this effort will thrust the burden onto the backs of Louisiana taxpayers, eventually saddling them with another federally mandated program they can ill afford. Louisianans have made it clear that they are sick and tired of carrying the water for an ever-expanding Federal Government. I commend our Governor for doing the right thing for our State and our country.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, last week, I introduced H.R. 5126, the Helping Save Americans' Health Care Choices Act. This important legislation restores the popular Health Savings Accounts and Flexible Spending Accounts, which are diminished through taxation and restrictions under ObamaCare. Millions of Americans rely on HSAs to cover deductibles, insurance copayments, over-the-counter medications, and a plethora of other medical expenses. Furthermore, it is an excellent tool to cut health care costs while ObamaCare, itself, provides no such tools. I find it extremely ironic that the name of the current law, the Patient Protection and Affordable Care Act, betrays the fact that it drives up costs for patients and for their employers. If you truly support health care affordability, I ask all of you to support H.R. 5126, which restores this valuable tool that saves costs.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, the DOD's recently released Military Power Report on Iran should be a wake-up call for the President and the leadership here in Congress. While I am glad the Pentagon undertook this assessment, I and most Americans didn't need a report to confirm the Iranian threat is real and credible. Iran's extremist regime poses a significant danger to the United States and our allies, particularly Israel. Also, because of our failure to implement tough sanctions against Iran, many nations will feel the need to develop nukes, while we are reducing our stockpile and failing to modernize our nuclear inventory. In addition, we have halted the production of F-22s, allowed a window of vulnerability in missile defense, and have delayed development of the NextGen bomber. I hope the Democrat majority and the President do not shortchange the DOD again this year on key investments in ballistic missile defense, the NextGen bomber, and other vital initiatives to protect our homeland and our allies well into the future.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, the government takeover of health care just celebrated its 1-month birthday, and we are already seeing the disastrous effect it will have on our Nation's economy. Since the beginning of this debate, U.S. employers have warned that this bill would destroy American jobs and harm our fragile economy. Over the past few weeks, we've seen the real-life impact these job- killing tax hikes and health care costs are having on American employers. From AT&T to Caterpillar to Lockheed Martin, we have seen billions of dollars in losses to American companies which will result in further job losses, higher prices, and less choice for the American consumer. And to add insult to injury, actuaries at CMS working under Secretary Sebelius now confirm what most Americans already knew: health care costs will skyrocket as a result of this bill. The long-term effects of this bill are still not fully fleshed out, will be devastating to this country's economy, and are not worth the time and effort that we have put into it. Let's move forward to repeal this law.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, as millions of Americans, and the people in my State of Louisiana, file their income taxes today, they are reminded how they labor under a tax scheme that discourages hard work, investment and savings. Federal, State and local taxes claim almost 27 percent of the average American's income. This means the average taxpayer worked until April 9 this year just to make enough money to pay their taxes. Meanwhile, our budget deficit this year is a record $1.5 trillion, three times the highest Bush deficit. This tax increase equates to more than $2,100 for every person in the United States and explodes the President's pledge not to raise taxes on Americans earning less than $200,000. And now we hear that the administration is considering a value added tax which taxes goods and services at every point in the process. Mr. Speaker, when it comes to taxes and our budget, let me suggest that Americans are not undertaxed; Washington is overspending. It is time for Congress to cut taxes across the board and stop the wasteful spending programs.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, I rise today to commend MedCamps for 23 years of outstanding service in the State of Louisiana. Founded in 1987, MedCamps of Louisiana provides a summer camp experience to children with physical and mental disabilities such as spina bifida, cerebral palsy, autism, and epilepsy. Each week, free of charge, children come from across Louisiana to participate in a week- long, fun-filled camping experience at Camp Alabama in my district. Children participate in activities such as fishing, arts, crafts, nature hikes, canoeing, and many others. As a family physician for over 30 years, I know firsthand the important role that organizations such as MedCamps play in the lives of children with disabilities. I congratulate MedCamps on their outstanding service to our State and wish them all the best as they continue to serve the children of Louisiana.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, I rise today to commend Louisiana State Representative Patrick Williams, who is currently making his annual 226-mile walk from Shreveport, Louisiana, to the State capitol in Baton Rouge to raise awareness for autism and childhood obesity. Autism is a common and serious developmental disability in the United States, with one in 150 children likely to have some form of this disability. Representative Williams is also bringing attention to a serious factor affecting childhood obesity, nutrition in the home, especially among poor families. As a family physician for over 30 years, I support Representative Williams' efforts and look forward to working with him to address these important issues. I congratulate him on raising awareness for these two important issues and join my constituents in thanking him for his service to the great State of Louisiana.

Mr. FLEMING

Mr. FLEMING. Mr. Speaker, I rise in opposition to this flawed health care bill.

Mr. FLEMING

Mr. FLEMING. Madam Speaker, let me get to the point here. In this bill we have the other side says there's $500 billion that's going to be taken out of Medicare without one word of explanation how they're going to do it. They're going to take it to extend the life of Medicare. And they're going to count it to subsidize private insurance. Totally dishonest. Now I have here a memo from the Democratic Caucus, and just to quote in talking about this giddy CBO score that's supposed to show savings: Do not allow yourself to get into a discussion of details of CBO scores and textual narrative. Instead, focus only on the deficit reduction and number of Americans covered. Do not give them ground by debating details. For example, the March 11 letter has some estimates of discretionary cost not accounted in the total. Again, instead focus only on the deficit reduction and number of Americans covered. Finally, with regard to SGR, we know that that was carved out of this bill, $250 billion, so let's add that to the trillion that's not being accounted for, and I quote: ``Most health staff are already aware that our health proposal does not contain a `doc fix' . . . The inclusion of a full SGR repeal would undermine reform's budget neutrality. So, again, do not allow yourself . . . to get into a discussion of the details of CBO scores and textual narrative. Instead, focus only on the deficit reduction and number of Americans covered. `` . . . Leadership and the White House are working with the AMA to rally physicians' support for a full SGR repeal.'' So now we understand why the AMA is supporting this.

Mr. FLEMING

Mr. FLEMING. And if you would yield back for one moment. This will be the biggest increase in abortions since Roe v. Wade. And I yield back.

Mr. FLEMING. We have got only 1 or 2 minutes remaining, and I am going to turn the remainder of this over to Dr. Gingrey.

Mr. FLEMING. I thank you gentlemen for joining me this evening. I thank our audience. This has been again another productive discussion about health care. I ask that everyone going forward in the next 3 days pray for us. And I yield to the gentleman.

Mr. FLEMING. Reclaiming my time. In the last few moments that we have in our discussion, which I think has been a great discussion, and once again I thank the gentlemen for joining me this evening. You know, we are in the final hours of this, it would appear. And we don't know if it is going to pass or not. I suspect that if the votes were there, we would be voting on it today. So I do think that the American people still have an opportunity to reach out to those who have not committed, and even those who have. You know, we don't have even one single Republican that has voted for any of this except for one, and even he is not going to vote for it this time. So this is not a bipartisan bill except to the extent of its opposition. We have the Republicans, we have a good group of Democrats, and also particularly pro-life Democrats, and the American people. But, unfortunately, we have a big enough group, a large enough group, if you will, of Democrats who feel through their arrogance they can still trump the American people and those others. And, you know, when you are talking about monumental legislation, Mr. Speaker, we are not talking about a small little bill that maybe it is a financial bill and maybe there are some little deals that have to be made in the back so that we can pull a couple more votes. We are talking about a fundamental bill, perhaps the most important that has been voted on in more than 40 years that affects every American in the most intimate way. Yet we are in the situation with this where we are still up to sleazy deals. Anyway we can get it done, even if you hate the bill, get it done. We can fix it later. That is the craziest thing I have ever heard of. And I would be happy to yield to the gentleman, Dr. Broun.

Mr. FLEMING. Reclaiming my time. I am sure that my other colleague from Georgia has a few choice comments as well.

Mr. FLEMING. Reclaiming my time. And then one other deal that just slipped in on the House side is the North Dakota deal. There are carve- outs there. So the sweet deals have not stopped even though the Senate bill is complete. I understand that there have been in fact ambassadorships, like an ambassadorship to NATO has been offered for a ``yes'' vote. We have Members of Congress being carted around in Air Force One and certainly asked out to dinner and all sorts of things like that. Look, this is one-sixth of the economy. This is the future of our Nation for a century. Are we so lack of character that we are willing to sell our souls for just about nothing? I yield to the gentleman from Georgia.

Mr. FLEMING. Those are all great. I appreciate your adding some of the things I left out. This list is getting so long of all the special deals. And the way that the Democrats are attempting to bypass the Constitution is just really unbelievable, and it's making Americans awfully mad. The emails I'm getting are really showing me either people are extremely mad or extremely terrified. Now I would like to turn to the other gentleman from Georgia, Dr. Gingrey, and see, do you have other comments about the process? And by the way, I must say that the President, Nancy Pelosi, and even Harry Reid say the process doesn't count, that the American people don't care about the process, only the finished product. Well, that tells me that the ends justify the means, and I just don't agree with that. What say you, sir?

Mr. FLEMING. I thank the gentleman. I thank both gentlemen from Georgia for your comments and, again, your many years of experience as physicians. I would like to change the topic slightly, and that is to talk about process for a moment. Now, what I would really describe, this situation is one in which, as this debate continued, Mr. Speaker, as this debate continued through the year, it began to lose momentum almost immediately. We began to see the polls. At first, it was 50/50. Half America wanted this health care reform but didn't know much about it, the other half really didn't want it. As this debate has gone on and on and on and the news gets out, the acceptance of this has dropped. In fact, today it is at its lowest point that it's been. I think we are up to now 55 percent of Americans are against it and down in the 30s are actually for it. In fact, a CNN poll--and I'm sure that CNN wouldn't be considered as an extreme right-wing media outlet--shows that--they asked a question a little different way. What should we do with this bill? Seventy-five percent of Americans said either scrap it altogether and forget about it or start over again. And that's exactly where we are. We would like to start over again and pass commonsense reforms without the government takeover of health care. Well, anyway, as this thing has been losing steam, it has caused more and more difficulty for the other side of the aisle to get things passed, vote after vote. And we saw that there was such a reaction across the country that our good friend, Scott Brown, was elected to, believe it or not, Senator Kennedy's seat, something that no one could have imagined this time a year ago. And while he is an excellent candidate, something else had to be in play there, and we know what it is, and that is health care. Also, through the process to get it through the Senate, even with the 60 votes that already were there, it took special deals. I will just name them real quickly. The Louisiana purchase; $300 million to go to my State of Louisiana, which would seem ostensibly to be a good thing, but by signing this bill, the President would actually cause costs that would be far greater than the $300 million that we would receive. So the net result is money lost, not money gained. The Nebraska kickback, which everyone has hated. And, in fact, what it is going to do is probably it will pass in this reconciliation, if it is passed, will actually extend the same benefit to all States which is going to drive up taxes and cost. A $10 million earmark for a Connecticut hospital for Chris Dodd, our Senator, and certainly Gator aid, where every State will lose its Medicare Advantage except for the State of Florida. But if that wasn't enough, Mr. Speaker, now that we're in the House, we've got another situation. We're talking about reconciliation; that is, instead of sending it to the Senate in the final form and have it passed and get past the cloture rules over there, they want to slide it in under reconciliation, a mere 51 votes. But all of that being as bad as it is, now we're talking about the Slaughter solution. And I will pitch back to my friend, Dr. Broun, for his comments.

Mr. FLEMING. Mr. Speaker, I am going to be starting this hour on behalf of my colleagues from the GOP Doctors Caucus. Congressmen and Drs. Murphy and Gingrey are our two cochairmen. We make up a group of 10 M.D.s and 4 other professional health care workers, including a dentist, a psychologist, an optometrist. We have been meeting on a very regular basis throughout this debate. Perhaps this weekend we will have a culmination of quite a debate. And what a debate it has been all year. As I tell folks often, I ran in my election in 2008, my first election, on health care reform. I am a physician, a family physician of 30 years. I have enjoyed the practice of medicine. I still practice medicine when I go back to my district. And for this 30-year period I have learned a lot about the economics of health care, things that are so important. I have been through all phases. In the early days of Medicare, when we didn't have a lot of the restrictions and restraints that we have today; during the HMO days, where we had capitated care and the so-called gatekeeper; during the days when the CLIA laws came out that more or less outlawed laboratories for doctors' offices; of course the SGR days, sustained growth rate that we have been dealing with for the last 10 years. I have seen it all, and so have my colleagues. In fact, among us we have over 400 years of clinical experience. I would include our two physicians from the Senate in that group. What I want to talk about this evening is a little bit of background, and also we will kind of get into where we are with the latest situation. One of the observations that I made early in my practice was that oftentimes economics actually controlled the decision-making more than the actual health care itself. I will give you a good example. I had a patient who required monthly blood tests to check his clotting factor because he was on anticlotting drugs because of chronic deep venous thrombosis. And I could not for the life of me get him to get those blood tests on a regular basis, not because he was afraid of needles, but simply he didn't want to pay the price. However, once we were brought under an HMO, health maintenance organization, and all of a sudden he didn't have nearly the out-of- pocket expenses that he would have had, not only did he want to have the blood tests, but he wanted to have many other tests as well, things far beyond anything that I could conceive would be a benefit to him. So for him it was a value issue. Since he wasn't paying and somebody else was paying, well, let's utilize as much as we can so I get my money's worth for what I am getting. One of the things I like to tell people when I speak to groups is think of health care consumption like a credit card. If I were to give you a credit card that has a limit of $10,000 on it and I said to you, buy whatever you need, but nothing that you just want. I often ask the crowd, ``What would you buy?'' And of course people come back with, well, I would buy probably a new shotgun to go hunting, or camo, or perhaps some physical fitness equipment, or a treadmill, something of that nature. Things that maybe I am not willing to pay out of pocket for, but if it's your money, then I'm willing to pay it. This, Mr. Speaker, is really the core of the problem when it comes to cost. There are two areas of our economy in which cost has gone up more rapidly than inflation. One is education and the other is health care. And it just happens that those are the two areas in which a third party, in the case of education it is the government who pays for that, and in the case of health care it is both government and private insurance that pays the main balance of the bills. So from that I have observed that if ever we are going to deal with increasing coverage, which is really what this is all about, how do we increase coverage, in order to do that we are going to have to find a way to lower the cost. I have agreement among all of my colleagues on the Republican side to just that. In order to have more coverage, we have got to lower the cost. And we have to do it fundamentally. This bill that is before us that we may vote on within the next 3 days, it has a lot of things in it. It has 3,000 pages, it has over a hundred mandates and boards. It has three specific boards of unelected bureaucrats who make decisions about what doctors are going to be paid, what is going to be in your insurance policy, many things about your life that you would otherwise have control of. But the one thing it does not do, Mr. Speaker, is it does not address cost. And so I can say to you that fundamentally if we are going to at some point in time address cost in health care, there is one of two ways: either we look at it on the doctor-patient level, where the doctor and the patient, who make the majority of decisions that impact cost, we either give them incentives and we also give them some responsibility, some accountability for cost, in which case if that cost is lowered as a result of accountability for them, then it lowers it for the entire system. That has been proven to work time after time. For instance, as soon as health care insurance began to cover more and more out-of-pocket expenses, we began to see over the years the cost of insurance going up far faster than the inflation rate. In recent years, we have come up with a tool to counteract that, and that is health savings accounts. I instituted that with my small businesses, which are apart from my medical practice, approximately 6 years ago. And it was considered to be sort of revolutionary. And there was a little angst among employees, what is this going to be like? Because our deductible is going to go up. But I committed to them that the incremental increase in what the policy costs would be, I am going to put it in their tax-free account which they can use for any health care purchase they like. Despite their reticence at first, they quickly came on because what they found is that now instead of being free utilizers of health care and running costs up because it's a use-it-or-lose-it proposition, now they have money in the bank; and if they make good, wise, savvy consumer decisions, they can choose generic drugs instead of brand name and save hundreds of dollars. They can shop around costs for certain procedures, certain doctors. It works very effectively. In fact, I would love to see that in health care reform at some point. It is not contained in this bill. We could even do that for Medicare and for Medicaid, put money in the bank on their behalf. Not out of pocket, mind you, but it is the insurance money or the Medicare money that goes in there to be spent on their behalf. Because if they are saving money for themselves, they are saving it for the system at large. What we are going to see here with this bill if it comes to law is just the opposite. Nothing to commit the doctor and the patient into controlling cost. In fact, in many ways it lowers the out-of-pocket expenses to a point where the patient behavior, the consumer behavior is unaffected by cost. And yet the consumer and the doctor are making those choices. Now, there will be, of course, layers and layers and layers of bureaucrats who will be controlling from Washington how things are paid. No question about it. And they will be attempting to control people's lives, what they eat, how they eat, what they weigh, whether they smoke or whatever. But unfortunately, there is no way that Washington, D.C. can micromanage human behavior. Attempts will be made with this bill, there is no question about it, but it will not work. So then there will have to be plan B. How will we save money? And what we found in every case, whether it is Tennessee, which attempted this some years ago, Massachusetts, which has attempted this much more recently, Canada, the United Kingdom, most Western European countries, Australia, every one of them, this is what has happened. The plan works nicely at first. People get less out-of-pocket cost. They can go to the doctor they want. Everything works beautifully. But then all of a sudden the costs begin to explode and they go far beyond anything that has been predicted or budgeted. And then what happens? Somewhere costs have to be controlled. And how do they do that? They do that through rationing and long lines. Every single case. Just the other day TennCare cut its Medicaid visits from unlimited down to eight visits a year. That is exactly the way it happens every time. Massachusetts, they are way over what their budget is. And as a result of that, they have come to a point now where they are actually reaching out to the Federal Government to control that. So just to kind of conclude this discussion about cost itself, either you start with lowering costs by using commonsense methodologies of the free market, with transparency and with turning the patient into a savvy consumer who has all the choices before him or her and can make the best choices for quality and for cost, therefore improving the quality and lowering the cost, or you can go to a top-down, government- run, government takeover system in which a Federal bureaucrat will be walking with you every step of the way. I have been joined here tonight by one of my colleagues, again as I alluded to a little earlier, Congressman Dr. Phil Gingrey from Georgia, a cochair of the GOP Doctors Caucus. In fact, it was his leadership that led us here tonight for one of many doctor caucus discussions and debates. He ran a little bit late because he had a tele-town hall back to his district. But he has now joined us. So I am going to yield to the gentleman, the obstetrician of many years from Georgia.

Mr. FLEMING

Mr. FLEMING. I thank the gentleman, and once again the Chamber this evening is filled with gentlemen that I admire and I'm learning from here in my first term in Congress. I certainly thank each one of you for your leadership. I just want to hit one thing before we get back to the topic of the Constitution, which is so important, and the process. I listened some to the hour before last, the women. There was a women's leadership hour on the other side of the aisle. Attractive women, nice ladies. We see them every day. We work with them. We happen to have a different worldview. And much of what they talked about was the human element, how this affects human beings. How this affects folks. Individual situations where someone loses their insurance and they run into problems and so forth. And I want to get back to that just for a moment. And here's why. We, the three physicians that are here, and our friend, Mr. King, we've all seen situations--health care problems, situations where people develop cancer, heart disease, what have you. And we want the best. We want health care reform. In fact, I campaigned on health care reform, but of course I had no idea that health care reform could in any way be a takeover of the health care system, but simply using a scalpel to fix the problems. But let me talk about, again, the human issue, and that is, let me remind my friends that coverage does not mean access. Coverage does not mean access to care. And I'll give you an extreme example. Look at Cuba today. In Cuba, 100 percent coverage. Care is free. The problem is you can't get care. They have one colonoscope for the whole country. Yeah, antibiotics are free. If you get pneumonia, you're still not getting any antibiotics. The same is true in North Korea. The same is true with the Soviet Union. Socialized, centralized economies do not work. They create spot shortages and sometimes extreme shortages. So let's look at Western European countries and Canada. What do we see there? Again, government-run health care. We talked in the previous hour about the fact that there's two ways to control cost: either do it by investing the patient and the doctor into it or have the government sort of control it. But the only way the government can actually save money is to create long lines and rationing. So if you look at Canada, we had both doctors and patients come and testify before us several months ago. I think some of the Members here were there. And what we heard was really, I think, spine-tingling. We heard the situation of a young mother who developed a spinal condition which left her wearing adult diapers. And there was a permanent treatment for her problem, a surgical treatment. Unfortunately, she had to wait years to get it. When she asked them, Why can't I have this surgery? I'm a young mother, I have a husband, and yet I have to wear diapers because I'm fully incontinent. The answer to her by her doctor was, You haven't suffered enough. You haven't suffered enough. Yes, health care is free in Canada, but you have to wait as much as 2\1/2\ years to get an MRI scan, and then you have to wait in line to get whatever it is. And it's not unusual for doctors in Canada to say, Yes, you have cancer, Mrs. Smith. We'll watch it. You will not hear a doctor in the United States tell you, You have cancer, and we'll watch it. The doctor may say it's untreatable, but he's not going to watch it if he thinks that there's any chance at all that there's either a cure or at least palliative care. Then finally we look at--let's go up a couple thousand feet and look overall. Two of the most important cancers in this country--prostate cancer and breast cancer. One in six women get breast cancer, and something like 60 percent of men over age 90 get prostate cancer. And look at the death rates. They're not comparable. The survival rates in the United States of America are far above those in Canada and the U.K. for two reasons. Number one, in the case of breast cancer, the government says it cannot afford mammograms, which are saving lives in the United States, and they cannot afford the more expensive and innovative chemotherapeutic drugs which are saving lives. So I just wanted to bring this down to the human element because we're talking about process, as we should, and we're talking about the economics, as we should, and we know they don't work. But I hear what these ladies are saying, that there is suffering out there. But again, bankrupting our health care system is not going to save lives or to free people from pain.